Provider Demographics
NPI:1568640977
Name:GEIST, LORIANE ROBIN (LMT)
Entity Type:Individual
Prefix:
First Name:LORIANE
Middle Name:ROBIN
Last Name:GEIST
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:
Other - Last Name:GEIST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:304 N MERIDIAN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-7634
Mailing Address - Country:US
Mailing Address - Phone:850-878-4432
Mailing Address - Fax:
Practice Address - Street 1:304 N MERIDIAN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-7634
Practice Address - Country:US
Practice Address - Phone:850-878-4432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA18372174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLC-7597OtherBLUE CROSS BLUE SHIELD